EP1746859B1 - Apparatus and method for fitting a hearing aid - Google Patents

Apparatus and method for fitting a hearing aid Download PDF

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Publication number
EP1746859B1
EP1746859B1 EP06014535A EP06014535A EP1746859B1 EP 1746859 B1 EP1746859 B1 EP 1746859B1 EP 06014535 A EP06014535 A EP 06014535A EP 06014535 A EP06014535 A EP 06014535A EP 1746859 B1 EP1746859 B1 EP 1746859B1
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Prior art keywords
audiometer
patient
hearing aid
hearing
ear
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German (de)
French (fr)
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EP1746859A1 (en
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Hans-Rainer Kurz
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    • H—ELECTRICITY
    • H04—ELECTRIC COMMUNICATION TECHNIQUE
    • H04R—LOUDSPEAKERS, MICROPHONES, GRAMOPHONE PICK-UPS OR LIKE ACOUSTIC ELECTROMECHANICAL TRANSDUCERS; DEAF-AID SETS; PUBLIC ADDRESS SYSTEMS
    • H04R25/00—Deaf-aid sets, i.e. electro-acoustic or electro-mechanical hearing aids; Electric tinnitus maskers providing an auditory perception
    • H04R25/70—Adaptation of deaf aid to hearing loss, e.g. initial electronic fitting
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/30—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/12—Audiometering
    • A61B5/121—Audiometering evaluating hearing capacity
    • H—ELECTRICITY
    • H04—ELECTRIC COMMUNICATION TECHNIQUE
    • H04R—LOUDSPEAKERS, MICROPHONES, GRAMOPHONE PICK-UPS OR LIKE ACOUSTIC ELECTROMECHANICAL TRANSDUCERS; DEAF-AID SETS; PUBLIC ADDRESS SYSTEMS
    • H04R2460/00—Details of hearing devices, i.e. of ear- or headphones covered by H04R1/10 or H04R5/033 but not provided for in any of their subgroups, or of hearing aids covered by H04R25/00 but not provided for in any of its subgroups
    • H04R2460/13—Hearing devices using bone conduction transducers

Definitions

  • the invention relates to a method for configuring a hearing aid for a person in which a test tone-generating audiometer and a patient-worn open headphones connected to the audiometer are used to transmit test tones generated by the audiometer.
  • test tones of the audiometer over a standing on the table speakers are issued, errors occur.
  • the patient is still confronted with other sources of noise from his environment.
  • the test signal on the way between the speaker and the patient decreases with the square of the distance.
  • test tones emerging from the closed headphones or from the speaker standing on the table are applied to the eardrum of the patient, its individual stiffness must also be taken into account. This causes another error.
  • the configuration of the hearing aid performed with the known devices is inaccurate.
  • the configuration is a closed-loop control of the parameters of closed headphones, hearing aid, residual volume of the ear canal, stiffness of the eardrum, ear resonance, earmold and peripheral and central processing.
  • This control loop is not reproducible.
  • the weakest link in this loop determines the quality of the acoustic signal.
  • the configuration of the hearing aid is turned off solely on the subjectively perceived information of the patient.
  • the feeling of the patient is clouded by the mentioned errors, the patient will often be tired of the adjustment procedure and give no objective information. He only reports hearing impressions known to him and not impressions that are necessary for learning to hear, since natural hearing is considered normal by alienation.
  • implants In addition to the use of hearing aids, the use of implants has also been proposed in the prior art. These implants can be placed in the ear if hearing is lost. The implants replace the auditory cells, the wearer of such an implant is able to hear again and is also able to develop a speech understanding. With the implants, it is possible to first reach or easily overcome the hearing threshold of the patient.
  • the invention has for its object to provide a method of the type mentioned, with a better configuration of a hearing aid by achieving or easily overcome the hearing threshold of the patient succeeds.
  • Threshold test signals should also be guaranteed as perceptions, such as signals of comfortable hearing and the discomfort threshold.
  • the procedural solution to the problem, for which independent protection is claimed is characterized in that the patient is equipped with a hearing aid, that on the audiometer different, fixed signal strengths are set and that a configuration of the hearing aid depending on the individual hearing of the patient is performed, with the hearing aid, the signal of the audiometer is amplified frequency-specific until it reaches the hearing threshold of the patient.
  • the hearing aid can be connected to a control device, such as a personal computer, to perform the optimal configuration of the hearing aid.
  • the audiometer now serves only as a signal source, the audiometer function is taken over by the desktop of the hearing aid.
  • the audiometer used as the signal source preferably has all supersatellite tests, e.g. Langenbeck noise audiometry, SISSI test and Fowler test.
  • the audiometer is preferably multi-channel, it can also offer at the same time air duct and bone conduction multiple channels of different frequencies and levels also suprathreshold.
  • the audiometer is preferably additionally equipped with a plug-in earphone in the auditory canal of the opposite ear to the Meßohrs to be activated listener to transmit signals e.g. to convey for reinforcement
  • the test tones used are freely selectable and correspond to the volume of a normal hearing.
  • the test tones can have all possible parameters. They pass the hearing aid, passing the earmold, into the auditory canal of the patient and are introduced into the brain via the peripheral and central ear organs.
  • the aim is to first determine the hearing threshold of the patient with the test tones.
  • the audiometer or other measuring device e.g. a signal with the strength of the hearing threshold of the patient, if he were healthy, firmly offered. Since the patient has a hearing problem, he does not hear anything at first. Now the signal is further amplified frequency specific with the hearing aid until the patient's threshold of hearing is reached neuronally. He can then provide objective information about when this happens.
  • the hearing care professional can configure the hearing aid so that the hearing threshold of the patient is reached with normal insertion of the hearing aid.
  • the patient is able to process sound waves in his neuronal areas, so that a neural network can re-train. The patient can learn to hear again.
  • the use of an open headphone ensures that the loudspeaker is directly assigned to the patient's ear.
  • the headset is open so that it does not close the patient's ear canals.
  • the headset has two speakers as usual so that both ears of the patient can be treated without the need to reposition the headset.
  • the hearing device of the patient can be used to influence these signals.
  • the hearing aid then works as an audiometer.
  • the hearing device preferably has a particularly calibrated desktop via which it can be controlled or programmed.
  • all control functions that the audiometer has with respect to the test signal can also be provided in the case of the desktop-controlled hearing device.
  • the desktop is freely programmable, its functions can be linked to the functions of the audiometer. If required, audiometer functions can also be performed via the desktop programming the hearing aid.
  • the desktop of the hearing aid can be used in the hearing aid, but it can also be arranged in an external and connected to the hearing aid control device.
  • This control device is, for example, a personal computer.
  • the selected test tones of the audiometer may be shirp signals, speech map signals or narrowband signals.
  • the headphone may additionally comprise at least one bone conduction earphone. This can be used to dupe an ear, especially a better hearing.
  • the inserted audiometer can also use long-wave or long-pulse signals, such as sinusoidal signals. To find the hearing threshold of the patient, however, the generally short-pulse signals are used according to the invention.
  • the desktop-controlled hearing aid can be arranged in the auditory canal of a patient in-situ probe connected to a measuring device and in this way it is checked whether the used as an audiometer desktop of the hearing aid also reaches the desired thresholds.
  • the result of the control can be displayed optically or acoustically.
  • the in situ probe is arranged at the entrance of the auditory canal of a patient. In addition to the aforementioned control, this probe can also check by their interconnection with a measuring device, whether the right sound pressure peak of the headphone is given. With the help of the measuring device to substitution and / or Komparationshabilit can be applied.
  • a computer tomograph can be used, the results of which can be used for monitoring and for programming via the calibrated desktop of the hearing aid.
  • a measurement method can then proceed in such a way that low frequencies are grouped together according to choice and level together in the field of Störlärms deliver a signal which is so intense that noise above the low-frequency hearing threshold of the subject to be measured, so the surrounding noise ( mainly low-frequency species) is suprathreshold, without provoking an upward masking of the high frequency components to be measured (similar to the Carhardt test or Langenbeck noise audiometry).
  • the surrounding noise mainly low-frequency species
  • Langenbeck noise audiometry Similar to the Carhardt test or Langenbeck noise audiometry.
  • For inner ear damaged it is e.g. in the SISSI test, it is much easier to hear increments with 1dB or more intensity increase than normal hearing people.
  • measuring high frequency, low energy but rich in information thresholds for voice guidance of consonants is further measurable when they are louder than the masking sounds
  • FIG. 1 An embodiment from which further inventive features result is shown in the drawing.
  • the sole figure of the drawing shows schematically a device according to the invention for configuring a hearing aid.
  • the device in the figure has an audiometer 1.
  • the audiometer 1 may generate different acoustic signals from each other. These signals are given via a cable connection 2 on a headphone 3.
  • the headphone 3 is an open headphone. On a frame 4, two open speakers 5 are arranged, each speaker 5 is assigned to an ear 6 of the patient.
  • a hearing aid 7 is used in the right ear 6 of the patient.
  • the switched-on hearing aid 7 is arranged in the auditory canal of the right ear 6, it is in direct contact with the internal organs 8 of the ear 6. Starting from the internal organs 8, a stimulus line indicated by an arrow 9 takes place to the brain 10 of the patient.
  • test tones pass through the auditory canal with the hearing device 7 without a change by the hearing aid 7.
  • the internal organs 8 are stimulated and, when the threshold of hearing is exceeded, a stimulation line occurs along the arrow 9 Brain 10.
  • the patient can give feedback.
  • the hearing device 7 is now configured via a connection indicated by the dashed arrow 11 with an adjustment system 12 such that upon the impact of normal acoustic signals an excitation of the brain 10 takes place and thus the patient's sense of hearing is improved.

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  • Physical Education & Sports Medicine (AREA)
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  • Medical Informatics (AREA)
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  • Public Health (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
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  • Fittings On The Vehicle Exterior For Carrying Loads, And Devices For Holding Or Mounting Articles (AREA)

Abstract

The device has an audiometer (1) for producing short pulsed test tones such as speech-map signals. An open loudspeaker (5), which is provided near the ear (6) of a patient, is attached to the audiometer for transmitting the test tones. The loudspeaker is attached to a headphone, and a desktop computer is assigned to the hearing aid. A probe is arranged in an auditory canal of the patient, where the probe is attached to a measuring equipment. An independent claim is also included for a method for configuring a hearing aid for a person.

Description

Die Erfindung betrifft ein Verfahren zum Konfigurieren eines Hörgerätes für eine Person, bei dem ein Testtöne erzeugendes Audiometer und ein an das Audiometer angeschlossener, vom Patienten getragener, offener kopfhörer zum Übertragen von von dem Audiometer erzeugten Testtönen verwendet wird.The invention relates to a method for configuring a hearing aid for a person in which a test tone-generating audiometer and a patient-worn open headphones connected to the audiometer are used to transmit test tones generated by the audiometer.

Menschen mit Gehörproblemen werden häufig mit Hörgeräten ausgerüstet, um die Hörprobleme aufzuheben bzw. zu lindern. Dabei ist es erforderlich, die Hörgeräte an die konkreten Anforderungen jedes Patienten anzupassen. Die Patienten weisen voneinander verschiedene Hörleiden auf, diese können sich auch in voneinander verschiedenen Stadien befinden. Die Hörgeräte sind an diese verschiedenen Leiden und verschiedenen Stadien anzupassen.People with hearing problems are often equipped with hearing aids to overcome or alleviate hearing problems. It is necessary to adapt the hearing aids to the specific requirements of each patient. The patients have different hearing disorders from each other, these can also be in different stages. The hearing aids are to be adapted to these different ailments and different stages.

Um ein Hörgerät an einen Patienten anpassen zu können, ist es erforderlich, dessen Hörvermögen exakt zu ermitteln. Für dieses Ermitteln werden eingangs genannte Verfahren verwendet. Diese verwenden Audiometer oder objektive Meßgeräte, mit denen Testtöne erzeugt werden können, welche den Patienten zugeführt werden. Eine derartige Vorrichtung ist aus der US 2004/0204921 A1 bekannt.In order to adapt a hearing aid to a patient, it is necessary to determine its hearing accurately. For this determination, the aforementioned method are used. These use audiometers or objective gauges that can generate test tones that are delivered to the patient. Such a device is known from US 2004/0204921 A1 known.

Im Stand der Technik ist für das Zuführen der Testtöne ein genormter Kopfhörer vorgeschlagen worden. Dieser Kopfhörer umschließt das Ohr,
wobei ein genormtes geschlossenes Restvolumen von 20 cm3 verbleibt. Auf dieses Normmaß des Kopfhörers sind die bekannten Audiometer kalibriert. Problematisch ist aber, daß nicht bei jedem Patienten ein Restvolumen von 20 cm3 gegeben ist. Die Ohranatomien der Patienten sind verschieden. Aufgrund dieser Verschiedenheiten ist bei den Vorrichtungen nach dem Stand der Technik somit ein Fehler gegeben.In the prior art, a standard headphone has been proposed for supplying the test tones. This headphone wraps around the ear,
whereby a standardized closed residual volume of 20 cm 3 remains. The standard audiometer is calibrated to this standard size of the headphones. The problem is that not every patient has a residual volume of 20 cm 3 . The ear anatomy of the patients are different. Due to these differences, the prior art devices thus fail.

Auch wenn die Testtöne des Audiometers über einen auf dem Tisch stehenden Lautsprecher abgegeben werden, treten Fehler auf. Neben dem Ton aus dem Lautsprecher wird der Patient nämlich noch mit weiteren Geräuschquellen aus seiner Umgebung konfrontiert. Zudem nimmt das Testsignal auf dem Weg zwischen dem Lautsprecher und dem Patienten mit dem Quadrat der Entfernung ab.Even if the test tones of the audiometer over a standing on the table speakers are issued, errors occur. In addition to the sound from the speaker, the patient is still confronted with other sources of noise from his environment. In addition, the test signal on the way between the speaker and the patient decreases with the square of the distance.

Beim Auftreffen der aus dem geschlossenen Kopfhörer bzw. aus dem auf dem Tisch stehenden Lautsprecher austretenden Testtöne auf das Trommelfell des Patienten ist zudem noch dessen individuelle Steifigkeit zu berücksichtigen. Dadurch tritt ein weiterer Fehler auf.Moreover, when the test tones emerging from the closed headphones or from the speaker standing on the table are applied to the eardrum of the patient, its individual stiffness must also be taken into account. This causes another error.

Im Ergebnis ist die mit den bekannten Vorrichtungen durchgeführte Konfiguration des Hörgerätes ungenau. Die Konfiguration stellt sich als Regelkreis aus den Parametern geschlossener Kopfhörer, Hörgerät, Restvolumen des Gehörganges, Steifigkeit des Trommelfells, Ohreingangsresonanzen, Otoplastik (Ohrpaßstück) sowie periphere und zentrale Verarbeitung dar. Dieser Regelkreis ist nicht reproduzierbar. Das schwächste Glied in dieser Regelkreiskette bestimmt die Qualität des akustischen Signals. Allein auf die subjektiv empfundenen Auskünfte des Patienten wird die Konfiguration des Hörgerätes abgestellt. Das Empfinden des Patienten ist durch die genannten Fehler eingetrübt, der Patient wird häufig der Anpassungsprozedur überdrüssig sein und keine objektiven Auskünfte mehr geben. Er meldet nur noch ihm bekannte Höreindrücke und nicht Eindrücke, die zum Hören lernen notwendig sind, da natürliches Hören durch Entfremdung als normal gewertet wird.As a result, the configuration of the hearing aid performed with the known devices is inaccurate. The configuration is a closed-loop control of the parameters of closed headphones, hearing aid, residual volume of the ear canal, stiffness of the eardrum, ear resonance, earmold and peripheral and central processing. This control loop is not reproducible. The weakest link in this loop determines the quality of the acoustic signal. The configuration of the hearing aid is turned off solely on the subjectively perceived information of the patient. The feeling of the patient is clouded by the mentioned errors, the patient will often be tired of the adjustment procedure and give no objective information. He only reports hearing impressions known to him and not impressions that are necessary for learning to hear, since natural hearing is considered normal by alienation.

Im Stand der Technik ist neben dem Einsatz von Hörgeräten auch der Einsatz von Implantaten vorgeschlagen worden. Diese Implantate können in den Ohrbereich eingesetzt werden, wenn das Hörvermögen absolut verloren gegangen ist. Die Implantate ersetzen die Hörzellen, der Träger eines derartigen Implantates vermag wieder hören und vermag auch ein Sprachverständnis zu entwickeln. Mit den Implantaten gelingt es dabei zunächst, die Hörschwelle des Patienten zu erreichen bzw. leicht zu überwinden.In addition to the use of hearing aids, the use of implants has also been proposed in the prior art. These implants can be placed in the ear if hearing is lost. The implants replace the auditory cells, the wearer of such an implant is able to hear again and is also able to develop a speech understanding. With the implants, it is possible to first reach or easily overcome the hearing threshold of the patient.

Der Erfindung liegt die Aufgabe zugrunde, ein Verfahren der eingangs genannten Gattung aufzuzeigen, mit dem ein besseres Konfigurieren eines Hörgerätes durch Erreichen bzw. leichtes Überwinden der Hörschwelle des Patienten gelingt. Schwellennahe Testsignale sollen gleichfalls als Wahmehmungen garantiert werden, wie Signale angenehmen Hörens und der Unbehaglichkeitsschwelle.The invention has for its object to provide a method of the type mentioned, with a better configuration of a hearing aid by achieving or easily overcome the hearing threshold of the patient succeeds. Threshold test signals should also be guaranteed as perceptions, such as signals of comfortable hearing and the discomfort threshold.

Die verfahrensseitige Lösung der Aufgabe, für die selbständiger Schutz beansprucht wird, zeichnet sich dadurch aus, daß der Patient mit einem Hörgerät ausgestattet wird, daß am Audiometer voneinander verschiedene, feste Signalstärken eingestellt werden und daß eine Konfiguration des Hörgerätes in Abhängigkeit des individuellen Hörvermögens des Patienten durchgeführt wird, wobei mit dem Hörgerät das Signal des Audiometers bis zum Erreichen der Hörschwelle des Patienten frequenzspezifisch verstärkt wird.The procedural solution to the problem, for which independent protection is claimed, is characterized in that the patient is equipped with a hearing aid, that on the audiometer different, fixed signal strengths are set and that a configuration of the hearing aid depending on the individual hearing of the patient is performed, with the hearing aid, the signal of the audiometer is amplified frequency-specific until it reaches the hearing threshold of the patient.

Bei Verfahren zum Konfigurieren eines Hörgerätes wird im Stand der Technik nach der US 2004/0204921 A1 so vorgegangen, daß ein Audiometer verwendet wird, an dem variable Signalstärken eingestellt werden. Dieses variable Einstellen von lauten und leisen Signalen am Audiometer erfolgt nach dem erfindungsgemäßen Verfahren nicht. Vielmehr werden am Audiometer feste Signalstärken eingestellt, wobei z.B. kurzpulsige Signale fester Signalstärke, d.h. Lautstärke, verwendet werden. Diese Signale passieren zunächst das Hörgerät möglichst ohne eine Veränderung durch das Hörgerät, um die Hörschwelle des Patienten zu erreichen. Für den einzelnen Patienten wird dabei eine Signalstärke fest eingestellt, mit welcher seine Hörschwelle erreicht werden kann. Diese Signalstärke kann beispielsweise 0 dB oder auch 65 dB oder 90 dB bis zur Einstellgrenze betragen.In methods for configuring a hearing aid according to the prior art US 2004/0204921 A1 so proceeded that an audiometer is used, are adjusted to the variable signal strengths. This variable setting of loud and quiet signals on the audiometer is not carried out according to the inventive method. Rather, fixed signal strengths are set on the audiometer, eg short-pulse signals of fixed signal strength, ie volume, are used. These signals first pass through the hearing aid as possible without a change by the hearing aid in order to reach the hearing threshold of the patient. For the individual patient while a signal strength is fixed, with which his hearing threshold can be achieved. This signal strength can be for example 0 dB or even 65 dB or 90 dB up to the setting limit.

Die Erreichung der Hörschwelle des Patienten, erfolgt mit dem Hörgerät, beispielsweise an einem Desktop des Hörgerätes. Das Hörgerät kann dabei mit einer Steuereinrichtung, wie einem Personalcomputer, verbunden sein, um die optimale Konfiguration des Hörgerätes durchzuführen. Das Audiometer dient nunmehr lediglich als Signalquelle, die Audiometerfunktion wird durch den Desktop des Hörgerätes übernommen. Das als Signalquelle dienende Audiometer verfügt vorzugsweise über alle überschwelligen Tests, z.B. Langenbecksche Geräuschaudiometrie, SISSI-Test und Fowler-Test. Das Audiometer ist dabei vorzugsweise mehrkanalig, es kann zugleich bei Luftleitung und Knochenleitung mehrere Kanäle verschiedener Frequenzen und Pegel auch überschwellig zugleich anbieten. Das Audiometer ist dabei vorzugsweise zusätzlich mit einem Einsteckhörer in den Gehörgang des gegenüber dem Meßohrs liegende Ohr zu aktivierende Hörer ausgestattet, um Signale z.B. zur Verstärkung zu übermittelnThe achievement of the hearing threshold of the patient, carried out with the hearing aid, for example on a desktop of the hearing aid. The hearing aid can be connected to a control device, such as a personal computer, to perform the optimal configuration of the hearing aid. The audiometer now serves only as a signal source, the audiometer function is taken over by the desktop of the hearing aid. The audiometer used as the signal source preferably has all supersatellite tests, e.g. Langenbeck noise audiometry, SISSI test and Fowler test. The audiometer is preferably multi-channel, it can also offer at the same time air duct and bone conduction multiple channels of different frequencies and levels also suprathreshold. The audiometer is preferably additionally equipped with a plug-in earphone in the auditory canal of the opposite ear to the Meßohrs to be activated listener to transmit signals e.g. to convey for reinforcement

Bei dem erfindungsgemäßen Verfahren wird einerseits kein geschlossener Kopfhörer mit einem genormten Restvolumen verwendet. Damit ist dieser Fehler bereits ausgeschlossen. Es kommt aber auch kein entfernt vom Ohr positionierter offener Lautsprecher zum Einsatz, an dem viele Störgeräusche vorbeigelangen können. Es wird ein offener, kalibrierter Kopfhörer eingesetzt, um die Normfehler des geschlossenen Kopfhörers auszuschließen und um eine unmittelbare Einleitung der Testtöne in das Ohr zu gewährleisten.In the method according to the invention, on the one hand, no closed headphones with a standardized residual volume are used. This error is already excluded. But there is also no remote from the ear positioned open speaker used, can get past the many noise. An open, calibrated headset is used to rule out the standard errors of the closed headphone and to ensure an immediate introduction of the test tones in the ear.

Die eingesetzten Testtöne sind frei wählbar und entsprechen der Lautstärke eines Normalhörenden. Die Testtöne können alle möglichen Parameter aufweisen. Sie gelangen am Hörgerät vorbei, die Otoplastik passierend, in den Gehörgang des Patienten und werden über dessen periphere und zentrale Ohrorgane in das Gehirn eingeleitet. Ziel ist es, mit den Testtönen zunächst die Hörschwelle des Patienten zu ermitteln. Dazu wird mit dem Audiometer oder einem anderen Meßgerät z.B. ein Signal mit der Stärke der Hörschwelle des Patienten, wenn er gesund wäre, fest angeboten. Da der Patient ein Hörleiden hat, hört er zunächst nichts. Nun wird mit dem Hörgerät das Signal frequenzspezifisch weiter verstärkt, bis die Hörschwelle des Patienten neuronal erreicht ist. Er kann dann objektiv Auskunft darüber geben, wann dies eintritt. Anhand dieser objektiven Kenntnis ist es für den Hörgeräteakustiker möglich, das Hörgerät so zu konfigurieren, daß bei normalem Einsetzen des Hörgerätes die Hörschwelle des Patienten erreicht wird. Der Patient ist in der Lage, Schallwellen in seinen neuronalen Bereichen zu verarbeiten, so daß sich ein neuronales Netz neu ausbilden kann. Der Patient kann wieder hören lernen.The test tones used are freely selectable and correspond to the volume of a normal hearing. The test tones can have all possible parameters. They pass the hearing aid, passing the earmold, into the auditory canal of the patient and are introduced into the brain via the peripheral and central ear organs. The aim is to first determine the hearing threshold of the patient with the test tones. For this purpose, with the audiometer or other measuring device, e.g. a signal with the strength of the hearing threshold of the patient, if he were healthy, firmly offered. Since the patient has a hearing problem, he does not hear anything at first. Now the signal is further amplified frequency specific with the hearing aid until the patient's threshold of hearing is reached neuronally. He can then provide objective information about when this happens. Based on this objective knowledge, it is possible for the hearing care professional to configure the hearing aid so that the hearing threshold of the patient is reached with normal insertion of the hearing aid. The patient is able to process sound waves in his neuronal areas, so that a neural network can re-train. The patient can learn to hear again.

Bei dem erfindungsgemäßen Verfahren wird somit eine möglichst objektive Konfiguration des Hörgerätes vorgenommen. Die Parameter des Gerätes sowie bei der Konfiguration auftretende Fehlerquellen der Geräte nach dem Stand der Technik werden vermieden. Im Prinzip wird der Weg der Implantate beschritten, in der Weise, daß zunächst einmal die Hörschwelle des Patienten überhaupt objektiv erreicht wird.In the method according to the invention thus a possible objective configuration of the hearing aid is made. The parameters of the device as well as occurring in the configuration error sources of the devices of the prior art are avoided. In principle, the path of the implants is taken in such a way that, first of all, the hearing threshold of the patient is actually achieved objectively.

Durch den Einsatz eines offenen Kopfhörers ist gewährleistet, daß der Lautsprecher dem Ohr des Patienten unmittelbar zugeordnet ist. Der Kopfhörer ist offen, so daß er die Gehörgänge des Patienten nicht verschließt. Vorzugsweise weist der Kopfhörer wie üblich zwei Lautsprecher auf, so daß beide Ohren des Patienten behandelt werden können, ohne ein Umsetzen des Kopfhörers zu benötigen.The use of an open headphone ensures that the loudspeaker is directly assigned to the patient's ear. The headset is open so that it does not close the patient's ear canals. Preferably, the headset has two speakers as usual so that both ears of the patient can be treated without the need to reposition the headset.

Mit dem Hörgerät des Patienten kann eine Beeinflussung dieser Signale durchgeführt werden. Das Hörgerät funktioniert dann als Audiometer. Das Hörgerät weist dazu vorzugsweise einen insbesondere kalibrierten Desktop auf, über den es steuerbar bzw. programmierbar ist. Vorzugsweise können dabei alle Steuerungsfunktionen, über die das Audiometer in Bezug auf das Testsignal verfügt, auch bei dem desktopgesteuerten Hörgerät vorgesehen sein. Der Desktop ist frei programmierbar, seine Funktionen können mit den Funktionen des Audiometers verknüpft werden. So können bei Bedarf Audiometerfunktionen auch über den das Hörgerät programmierenden Desktop ausgeführt werden. Der Desktop des Hörgerätes kann dabei in das Hörgerät eingesetzt sein, er kann aber auch in einer externen und an das Hörgerät angeschlossenen Steuerungseinrichtung angeordnet sein. Diese Steuerungseinrichtung ist beispielsweise ein Personalcomputer. Mit dem Desktop des Hörgerätes können auch Signale für einen Knochenleitungshörer, der zu Meß- und/oder Vertäubungszwecken eingesetzt wird, erzeugt werden. Diese Vertäubungssignale werden als Rückschlüsse anhand der Nutzsignale gewonnen. Vertäubungssignale werden dabei über den Knochenschall oder Luftschall oder zugleich auch mit zeitlichen, pegelabhängigem Frequenzversatz bzw. entsprechenden Automatikfunktionen übertragen.The hearing device of the patient can be used to influence these signals. The hearing aid then works as an audiometer. For this purpose, the hearing device preferably has a particularly calibrated desktop via which it can be controlled or programmed. Preferably, all control functions that the audiometer has with respect to the test signal can also be provided in the case of the desktop-controlled hearing device. The desktop is freely programmable, its functions can be linked to the functions of the audiometer. If required, audiometer functions can also be performed via the desktop programming the hearing aid. The desktop of the hearing aid can be used in the hearing aid, but it can also be arranged in an external and connected to the hearing aid control device. This control device is, for example, a personal computer. With the desktop of the hearing aid also signals for a bone conduction listener, which is used for measuring and / or Verhäubungszwecken be generated. These masking signals are obtained as conclusions on the basis of the useful signals. Masking signals are transmitted via the bone sound or airborne sound or at the same time with temporal, level-dependent frequency offset or corresponding automatic functions.

Die gewählten Testtöne des Audiometers können Shirp-Signale, Speechmap-Signale oder Schmalband-Signale sein. Der Kopfhörer kann zusätzlich wenigstens einen Knochenleitungshörer aufweisen. Dieser kann dazu eingesetzt werden, ein Ohr, insbesondere ein besser hörendes, zu vertäuben. Das eingesetzte Audiometer kann auch langwellige bzw. langpulsige Signale, wie beispielsweise Sinussignale einsetzen. Zum Auffinden der Hörschwelle des Patienten werden aber die in der Regel kurzpulsigen Signale erfindungsgemäß eingesetzt.The selected test tones of the audiometer may be shirp signals, speech map signals or narrowband signals. The headphone may additionally comprise at least one bone conduction earphone. This can be used to dupe an ear, especially a better hearing. The inserted audiometer can also use long-wave or long-pulse signals, such as sinusoidal signals. To find the hearing threshold of the patient, however, the generally short-pulse signals are used according to the invention.

Zur Kontrolle der Arbeitsweise des Desktop-gesteuerten Hörgerätes kann eine im Gehörgang eines Patienten anordbare In-Situ-Sonde an eine Meßeinrichtung angeschlossen sein und auf diese Weise wird überprüft, ob der als Audiometer eingesetzte Desktop des Hörgerätes auch die gewünschten Schwellwerte erreicht. Das Ergebnis der Kontrolle kann optisch oder akustisch angezeigt werden. Die In-Situ-Sonde ist dabei am Eingang des Gehörganges eines Patienten angeordnet. Neben der vorgenannten Kontrolle kann diese Sonde durch ihre Verschaltung mit einer Meßeinrichtung auch überprüfen, ob der richtige Schalldruckpeckel des Kopfhörers gegeben ist. Mit Hilfe der Meßeinrichtung können dazu Substitutions- und/oder Komparationsverfahren angewandt werden. Statt einer In-Situ-Sonde kann auch ein Computertomograph eingesetzt werden, dessen Ergebnisse für die Überwachung eingesetzt werden können und zur Programmierung über den kalibrierten Desktop dem Hörgerät dienen.To control the operation of the desktop-controlled hearing aid can be arranged in the auditory canal of a patient in-situ probe connected to a measuring device and in this way it is checked whether the used as an audiometer desktop of the hearing aid also reaches the desired thresholds. The result of the control can be displayed optically or acoustically. The in situ probe is arranged at the entrance of the auditory canal of a patient. In addition to the aforementioned control, this probe can also check by their interconnection with a measuring device, whether the right sound pressure peak of the headphone is given. With the help of the measuring device to substitution and / or Komparationsverfahren can be applied. Instead of an in situ probe, a computer tomograph can be used, the results of which can be used for monitoring and for programming via the calibrated desktop of the hearing aid.

Bei einem Messverfahren kann dann so vorgegangen werden, daß tiefe Frequenzen nach Wahl in Gruppen zusammengefaßt werden und Pegel zusammenfassend im Bereich des Störlärms ein Signal abgeben, welches so intensiv ist, daß Störgeräusche oberhalb der niederfrequenten Hörschwelle des zu messenden Betroffenden, also der umgebende Störschall (hauptsächlich niederfrequenter Art), überschwellig vedeckt wird, ohne eine Aufwärtsmaskierung der zu messenden Hochfrequenzanteile zu provozieren (ähnlich des Carhardt-Testes oder Langenbeckschen Geräuschaudiometrie). Für Innenohrgeschädigte ist es z.B. beim SISSI-Test erheblicher einfacher, Incremente mit 1dB oder mehr Intensitätserhöhung herauszuhören, als Normalhörige. Trotz Anbietung eines Störschalls oberhalb der Hörschwelle in diesem Bereich zur Auslöschung von Umgebungsgeräuschen, ist das Messen hochfrequenter, energiearmer aber informationsreicher Schwellenwerte zur Sprachanbahnung von Konsonanten weiter meßbar, wenn diese lauter sind als die VertäubungsgeräuscheIn a measurement method can then proceed in such a way that low frequencies are grouped together according to choice and level together in the field of Störlärms deliver a signal which is so intense that noise above the low-frequency hearing threshold of the subject to be measured, so the surrounding noise ( mainly low-frequency species) is suprathreshold, without provoking an upward masking of the high frequency components to be measured (similar to the Carhardt test or Langenbeck noise audiometry). For inner ear damaged, it is e.g. in the SISSI test, it is much easier to hear increments with 1dB or more intensity increase than normal hearing people. Despite providing background noise above the audible threshold in this region for canceling ambient noise, measuring high frequency, low energy but rich in information thresholds for voice guidance of consonants is further measurable when they are louder than the masking sounds

Ein Ausführungsbeispiel, aus dem sich weitere erfinderische Merkmale ergeben, ist in der Zeichnung dargestellt. Die einzige Figur der Zeichnung zeigt in schematischer Weise eine erfindungsgemäße Vorrichtung zum Konfigurieren eines Hörgerätes.An embodiment from which further inventive features result is shown in the drawing. The sole figure of the drawing shows schematically a device according to the invention for configuring a hearing aid.

Die Vorrichtung in der Figur weist ein Audiometer 1 auf. Das Audiometer 1 kann voneinander verschiedene akustische Signale erzeugen. Diese Signale werden über eine Kabelverbindung 2 auf einen Kopfhörer 3 gegeben.The device in the figure has an audiometer 1. The audiometer 1 may generate different acoustic signals from each other. These signals are given via a cable connection 2 on a headphone 3.

Bei dem Kopfhörer 3 handelt es sich um einen offenen Kopfhörer. An einem Gestell 4 sind zwei offene Lautsprecher 5 angeordnet, wobei jeder Lautsprecher 5 einem Ohr 6 des Patienten zugeordnet ist.The headphone 3 is an open headphone. On a frame 4, two open speakers 5 are arranged, each speaker 5 is assigned to an ear 6 of the patient.

In das rechte Ohr 6 des Patienten ist ein Hörgerät 7 eingesetzt. Das eingeschaltete Hörgerät 7 ist im Gehörgang des rechten Ohres 6 angeordnet, es steht mit den inneren Organen 8 des Ohrs 6 in unmittelbarem Kontakt. Ausgehend von den inneren Organen 8 erfolgt eine mit einem Pfeil 9 angedeutete Reizleitung zum Gehirn 10 des Patienten.In the right ear 6 of the patient, a hearing aid 7 is used. The switched-on hearing aid 7 is arranged in the auditory canal of the right ear 6, it is in direct contact with the internal organs 8 of the ear 6. Starting from the internal organs 8, a stimulus line indicated by an arrow 9 takes place to the brain 10 of the patient.

Bei dem Beaufschlagen des Kopfhörers 3 mit kurzpulsigen Testtönen durch das Audiometer 1 passieren diese Testtöne den Gehörgang mit dem Hörgerät 7 ohne eine Veränderung durch das Hörgerät 7. Die inneren Organe 8 werden angeregt und es erfolgt bei Überschreiten der Hörschwelle eine Reizleitung entlang des Pfeils 9 zum Gehirn 10. Der Patient kann eine Rückmeldung geben. Das Hörgerät 7 wird nun über eine durch den gestrichelten Pfeil 11 angedeutete Verbindung mit einer Einstellanlage 12 derart konfiguriert, daß bei dem Auftreffen normaler akustischer Signale eine Anregung des Gehirns 10 erfolgt und somit das Hörempfinden des Patienten verbessert wird.When auditioning the headphone 3 with short-pulse test tones through the audiometer 1, these test tones pass through the auditory canal with the hearing device 7 without a change by the hearing aid 7. The internal organs 8 are stimulated and, when the threshold of hearing is exceeded, a stimulation line occurs along the arrow 9 Brain 10. The patient can give feedback. The hearing device 7 is now configured via a connection indicated by the dashed arrow 11 with an adjustment system 12 such that upon the impact of normal acoustic signals an excitation of the brain 10 takes place and thus the patient's sense of hearing is improved.

Claims (5)

  1. A method for configuring a hearing aid for a person, in which an audiometer generating test sounds and an open earphone which is connected to the audiometer and worn by the patient, is used for transmitting test sounds generated by the audiometer, wherein the patient is fitted with a hearing aid, fixed signal strengths which differ from one another are set on the audiometer and the hearing aid is configured as a function of the individual hearing capacity of the patient, characterised in that the signal of the audiometer is amplified in a frequency-specific manner with the hearing aid until the hearing threshold of the patient is reached.
  2. The method according to claim 1, characterised in that a signal strength of about 0 dB is set on the audiometer.
  3. The method according to claim 1 or 2, characterised in that a signal strength of about 65 dB is set on the audiometer.
  4. The method according to any one of the preceding claims, characterised in that a signal strength of above about 90 dB is set on the audiometer until the setting limit is reached.
  5. The method according to any one of claims 1 to 4, characterised in that the hearing aid is controlled by means of a desktop computer.
EP06014535A 2005-07-23 2006-07-13 Apparatus and method for fitting a hearing aid Not-in-force EP1746859B1 (en)

Applications Claiming Priority (2)

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DE102005061150A DE102005061150A1 (en) 2005-07-23 2005-12-21 Device and method for configuring a hearing aid

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DE202016101050U1 (en) 2016-02-25 2016-04-21 Audiosus Gmbh Device for configuring a user-specific hearing system
DE102017103808B3 (en) 2017-02-23 2018-05-30 Hörwelt Duisburg GmbH A method for patient-specific configuration of a hearing aid and method for generating test signals therefor

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US20090248085A1 (en) * 2008-03-31 2009-10-01 Cochlear Limited Tissue injection fixation system for a prosthetic device
CU23466A1 (en) * 2008-07-24 2009-12-17 Ct De Neurociencias De Cuba METHODOLOGY AND APPARATUS FOR THE OBJECTIVE DETECTION OF AUDITIVE DISORDERS
US8144909B2 (en) 2008-08-12 2012-03-27 Cochlear Limited Customization of bone conduction hearing devices
US8538033B2 (en) * 2009-09-01 2013-09-17 Sonic Innovations, Inc. Systems and methods for obtaining hearing enhancement fittings for a hearing aid device
WO2012127445A2 (en) 2011-03-23 2012-09-27 Cochlear Limited Fitting of hearing devices

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DE3205685A1 (en) * 1982-02-17 1983-08-25 Robert Bosch Gmbh, 7000 Stuttgart HOERGERAET
US6118877A (en) * 1995-10-12 2000-09-12 Audiologic, Inc. Hearing aid with in situ testing capability
US6366863B1 (en) 1998-01-09 2002-04-02 Micro Ear Technology Inc. Portable hearing-related analysis system
US6496585B1 (en) * 1999-01-27 2002-12-17 Robert H. Margolis Adaptive apparatus and method for testing auditory sensitivity

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Publication number Priority date Publication date Assignee Title
DE202016101050U1 (en) 2016-02-25 2016-04-21 Audiosus Gmbh Device for configuring a user-specific hearing system
EP3211920A1 (en) 2016-02-25 2017-08-30 audiosus GmbH Method and device for configuring a user-specific hearing system
DE102016103297A1 (en) 2016-02-25 2017-08-31 Audiosus Gmbh Device and method for configuring a user-specific hearing system
DE102016103297B4 (en) 2016-02-25 2019-02-21 Audiosus Gmbh Device and method for configuring a user-specific hearing system
DE102017103808B3 (en) 2017-02-23 2018-05-30 Hörwelt Duisburg GmbH A method for patient-specific configuration of a hearing aid and method for generating test signals therefor
WO2018153412A1 (en) 2017-02-23 2018-08-30 Hörwelt Duisburg GmbH Method for patient-specific configuration of a hearing aid and method for producing test signals therefor

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US20070019818A1 (en) 2007-01-25
EP1746859A1 (en) 2007-01-24
DE502006004281D1 (en) 2009-09-03
DK1746859T3 (en) 2009-11-02
ATE437533T1 (en) 2009-08-15

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